title: Usefulness of the anterolateral thigh flap with vascularized fascia lata for reconstruction of orbital floor and nasal surface after total maxillectomy.
abstract: OBJECTIVE
  The aim of this study was to describe a technique using the fascia lata (FL) component of the anterolateral thigh (ALT) flap to re-create the orbital floor and lateral nasal wall after total maxillectomy.
  
  
  METHODS
  Retrospective analysis of medical records.
  
  
  METHODS
  A total of 22 patients underwent maxillary reconstruction using a composite ALT-FL flap following cancer resection. All patients underwent total maxillectomies via the Weber-Ferguson approach. The ALT flap was harvested with the deep fascia of the thigh with the aim of using it for lining of the orbital floor and lateral nasal cavity. The FL was sutured to the palatine bone inferiorly, nasal bone and zygomatic bone superiorly, and nasopharyngeal mucosa posteriorly to provide an orbital floor and make a neonasal cavity.
  
  
  RESULTS
  There was 100% free flap survival. Speech was normal in eight (36%) patients, near normal in 10 (46%), and intelligible in four (18%). Seventeen (77%) patients gained a good facial appearance, and five (23%) a fair appearance. Sixteen (73%) patients complained of mild nasal crust formation, and the rest (27%) developed moderate crust.
  
  
  CONCLUSIONS
  Microvascular reconstruction using a composite ALT-FL flap provided a reliable fascial component for orbital floor and nasal surface reconstruction of total maxillectomy defects.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Catholic University of Korea, Seoul, Korea.
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Joo
authors.forename: Kwang-Jae
authors.initials: KJ
authors.lastname: Cho
authors.forename: Jun-Ook
authors.initials: JO
authors.lastname: Park
authors.forename: Min-Sik
authors.initials: MS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005206:Fascia Lata / Q000098:blood supply* / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008441:Maxillary Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009296:Nasal Cavity / Q000601:surgery; D009915:Orbit / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D013524:Surgical Flaps / Q000098:blood supply*; D015996:Survival Rate; D013848:Thigh / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
keywords: Maxilla; free tissue flaps; reconstructive surgical procedures; treatment outcome